DESCRIPTION: The goal of this five year research demonstration and education project is to determine if an intensive intervention using nurse home visitors can reduce asthma prevalence among children from low income households who begin wheezing in infancy. One hundred eighty infants and their parents who are Medicaid-eligible will be recruited from public health settings. About half of the children will be from minority families. Families will be randomly assigned to a nurse home visitor intervention group or a control group. In the intervention group, nurse home visitors will work with parents for one year to target allergens in the home, reduce environmental tobacco smoke, and improve the quality of maternal caregiving, particularly as it relates to asthma prevention and management. A control group will receive information related to preventing asthma. Repeated assessments of the targeted variables will be made in both groups. In addition, family history of asthma and children's IgE levels at enrollment will be assessed, since these variables are expected to interact with the targeted variables to affect outcome. Maternal psychological resources also will be assessed, as this factor has been associated with responsivity to home visitor interventions. Respiratory infections and use of anti-inflammatory medications will be monitored as possible mediating variables. All children will be followed to 4 years of age. Outcomes to be measured include asthma status, functional severity of asthma by maternal report and by cumulative symptom reports, pulmonary functions and IgE levels, quality of life and child behavioral adjustment, and health care use and costs. The principal investigator is Mary Klinnert, Ph.D., who is Chief of Pediatric Psychology at the National Jewish Center for Immunology and Respiratory Medicine and Associate Professor of Psychiatry at the University of Colorado Health Sciences Center. Co-investigators are Lanny Rosenwasser, M.D., Larry Borish, M.D., and Andy Liu, M.D.